Your Federal Quarterly Tax Payments are due April 15th Get Help Now >>

Attendance Record Template - DOC by knt16405

VIEWS: 170 PAGES: 2

Attendance Record Template document sample

More Info
									                        COUNTY BOARD OF DEVELOPMENTAL DISABILITIES
                             INDIVIDUAL ATTENDANCE RECORD TEMPLATE
                                      2010-11 PROGRAM YEAR
                                                                   PLEASE CHECK ONE:
                                                                                   Preschool/School ____
INDIVIDUAL INFORMATION
                                                                                   Adult Systems           ____
   Name: ______________________________ DOB: _____________
                                                                                   Early Intervention ____
Address: __________________________________________________
                                                                                   (see note at end)
            __________________________________________________


 SAMPLE
 CODES
   A         Facility is closed for Administrative reasons (conferences, holidays)
   C         Facility is closed for Calamity conditions
   E         Day enrollee Enters program, or re-enters the program if absent for more than six weeks
   F         First day of Preschool/School Program
   I         IFSP/IEP/IP meetings (no enrollees in attendance)
   H         Holidays
   L         Last day of Preschool/School Program
   PC        Program Closed (other reasons not noted, e.g., paid or unpaid vacations, spring break)
   V         Vacation period for enrollee (paid or unpaid vacation leave)
   W         Withdrawal from program; indicate whereabouts in explanation column
   S         Sickness or other causes not covered by above codes; excused absences
   SC        Staff Conference/professional development day
   SW        Staff Work day (no enrollees in attendance, not counted in minimum days)
   U         Unable to complete home or other community site visit (enrollee ill, family not home, etc.)




                                          FIRST QUARTER 2010/11
           JULY 2010                              AUGUST 2010                        SEPTEMBER 2010
 Su Mo Tu We Th Fr Sa                   Su Mo Tu We Th Fr Sa                 Su Mo Tu We Th Fr Sa
                    1   2   3             1   2   3   4   5   6   7                          1   2     3    4
   4   5    6   7   8   9 10              8   9 10 11 12 13 14                 5     6   7   8   9 10 11
 11 12 13 14 15 16 17                   15 16 17 18 19 20 21                 12 13 14 15 16 17 18
 18 19 20 21 22 23 24                   22 23 24 25 26 27 28                 19 20 21 22 23 24 25
 25 26 27 28 29 30 31                   29 30 31                             26 27 28 29 30


Explanation:                           Explanation:                         Explanation:
                                     SECOND Q UARTER 2010/11
           OCTOBER 2010                    NOVEMBER 2010                             D ECEMBER 2010
  Su Mo Tu We Th Fr Sa               Su Mo Tu We Th Fr Sa                      Su Mo Tu We Th Fr Sa
                          1   2            1   2   3   4   5   6                             1   2   3   4
   3   4     5   6   7    8   9        7   8   9 10 11 12 13                    5   6   7    8   9 10 11
  10 11 12 13 14 15 16               14 15 16 17 18 19 20                      12 13 14 15 16 17 18
  17 18 19 20 21 22 23               21 22 23 24 25 26 27                      19 20 21 22 23 24 25
  24 25 26 27 28 29 30               28 29 30                                  26 27 28 29 30 31
  31
Explanation:                        Explanation:                          Explanation:




                                      T HIRD QUARTER 2010/11
       JANUARY 2011                        FEBRUARY 2011                             MARCH 2011
  Su Mo Tu We Th Fr Sa               Su Mo Tu We Th Fr Sa                      Su Mo Tu We Th Fr Sa
                              1                1   2   3   4   5                        1    2   3   4   5
   2   3     4   5   6    7   8       6    7   8   9 10 11 12                   6   7   8    9 10 11 12
   9 10 11 12 13 14 15               13 14 15 16 17 18 19                      13 14 15 16 17 18 19
  16 17 18 19 20 21 22               20 21 22 23 24 25 26                      20 21 22 23 24 25 26
  23 24 25 26 27 28 29               27 28                                     27 28 29 30 31
  30 31
Explanation:                        Explanation:                              Explanation:




                                     FOURTH QUARTER 2010/11
            APRIL 2011                         MAY 2011                                 JUNE 2011
 Su Mo Tu We Th Fr Sa                Su Mo Tu We Th Fr Sa                      Su Mo Tu We Th Fr Sa
                         1    2       1    2   3   4   5   6   7                             1   2   3   4
  3    4     5   6   7   8    9       8    9 10 11 12 13 14                     5   6   7    8   9 10 11
 10 11 12 13 14 15 16                15 16 17 18 19 20 21                      12 13 14 15 16 17 18
 17 18 19 20 21 22 23                22 23 24 25 26 27 28                      19 20 21 22 23 24 25
 24 25 26 27 28 29 30                29 30 31                                  26 27 28 29 30


Explanation:                        Explanation:                              Explanation:




   Total Preschool/School days available to enrollees:             ________
   Total Adult Systems days available to enrollees:                ________
   Note: Because Early Intervention (EI) services are mandated federally to be available year
   round, provided in natural environments, and delivered through the state IFSP form,
   documentation of EI services must reflect the services as specified on the IFSP outcome and
   service summary pages, rather than days in attendance at a center based location.

								
To top